The role of diffusion-weighted MRI and contrast-enhanced MRI for differentiation between solid renal masses and renal ce
- PDF / 2,717,421 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 23 Downloads / 165 Views
KIDNEYS, URETERS, BLADDER, RETROPERITONEUM
The role of diffusion‑weighted MRI and contrast‑enhanced MRI for differentiation between solid renal masses and renal cell carcinoma subtypes Aslı Serter1 · Mehmet Ruhi Onur2 · Ganime Coban3 · Pelin Yildiz3 · Abdullah Armagan4 · Ercan Kocakoc5 Received: 17 May 2020 / Revised: 22 August 2020 / Accepted: 3 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To assess the value of diffusion-weighted magnetic resonance imaging (DW-MRI) and contrast-enhanced MRI (CE-MRI) for differentiation between benign and malignant solid renal masses, renal cell carcinoma (RCC) subtypes, oncocytomas, and lipid-poor angiomyolipomas (LP-AML). Methods Minimum or lowest ‘apparent diffusion coefficient’ (ADC1) and representative ADC values (ADC2) of 112 renal masses (n: 46 benign renal mass, n: 66 malignant renal mass) were measured on DW-MRI images (b 50, 400, 800 s/mm2). Signal intensity (SI) measurements were performed in normal renal parenchyma and most avid enhanced area of the renal masses at precontrast, corticomedullary, and nephrographic phases on CE-MRI. Contrast enhancement rate (CER) and contrast enhancement index (CEI) values of renal masses were compared between benign-malignant renal masses and RCC subtypes, oncocytomas, and LP-AMLs. Results There was no significant difference between ADC1, ADC2 values, and SI of benign and malignant renal masses (p = 0.721, p = 0.255, p = 0.872). Mean ADC1 and A DC2 values of clear cell RCCs were significantly higher than nonclear cell RCCs (p = 0.005 p = 0.002). Mean CER value of clear cell RCCs was significantly higher than nonclear cell RCCs in nephrographic phase (p = 0.003). Mean CEI values of clear cell RCCs were significantly higher than nonclear cell RCCs in the corticomedullary and nephrographic phase (p = 0.027 vs. 0.008). LP-AMLs were differentiated from other renal masses with wash-out phenomenon. Conclusion Combined usage of ADC, SI, CER, and CEI values may be useful for discrimination between RCC subtypes, oncocytomas, and lipid-poor AMLs. Keywords Kidney · Diffusion-weighted MRI · Magnetization transfer contrast imaging · Benign neoplasms · Malignant neoplasms
Introduction
* Mehmet Ruhi Onur [email protected] 1
Private Lokman Hekim Esnaf Hospital, Fethiye, Muğla, Turkey
2
Faculty of Medicine, Department of Radiology, Hacettepe University, Ankara, Turkey
3
Department of Pathology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
4
Uromer Urology Center, Atakoy Towers, Istanbul, Turkey
5
Bahcelievler Medical Park Hospital, Istanbul, Turkey
Benign and malignant solid renal masses may present with similar imaging features on cross-sectional imaging techniques. Differentiation between benign and malignant solid renal masses with imaging techniques is crucial for the management and treatment of these masses since malignant renal masses necessitate surgical excision and further chemotherapy with targeted agents while follow-up imag
Data Loading...
